Treatment Cost of Heavily Treatment-Experienced Adult Patients With Multi-Drug Resistant HIV-1 Infection in Brazil
Speaker(s)
Alemar M1, Bernardino G1, Tanaka S1, Rodrigues L1, Jacob I2, Sampietri I3, Silva D1, Meirelles IO4
1GSK, Rio de Janeiro, Rio de Janeiro, Brazil, 2ViiV Healthcare, Brentford, UK, 3GSK, São Paulo, SP, Brazil, 4IQVIA, Real-World Insights, Brazil, Sao Paulo, Sao Paulo, Brazil
Presentation Documents
OBJECTIVES: Patients with multidrug-resistant (MDR) HIV-1 infection and CD4+ cell deficiency face significant challenges in their treatment. Low CD4+ cell counts may be associated with a higher incidence of opportunistic infections, HIV/AIDS complications, and a need for complex and potentially more expensive therapies. The aim of this study was to analyze the direct costs of a heavily treatment-experienced patient with MDR HIV-1 infection.
METHODS: A health state transition model was developed to estimate the direct costs over a lifetime horizon of a heavily treatment-experienced patient with MDR HIV-1 infection. The following resources were captured: antiretroviral therapy (ART) regimens; outpatient, emergency, and hospitalization visits; monitoring tests (e.g.: HIV-1 RNA, CD4+ cell count, ART resistance); opportunistic infection (OI) prophylaxis; adverse event management; end-of-life care; and AIDS-defining events (OI management).
RESULTS: The total cost of a patient is BRL 100,528, 77% of which is related to ART regimens, with maraviroc and enfuvirtide representing the costly treatments and being included in 19% and 10% of optimized background therapy (OBT) regimens, respectively. The remaining 23% of costs are allocated to HIV care. Of this portion, the most significant distribution of costs is observed in patients with the lowest CD4+ cell count: CD4+ <50: R$9,047; CD4+ 50-<200: R$7,940; CD4+ 200-<350: R$2,884; CD4+ 350-<500: R$1,258; CD4+ ≥500: R$810. Opportunistic infection prophylaxis accounted for BRL 155 and end-of-life care BRL 1,455.
CONCLUSIONS: Patients with lower CD4+ cell counts require a higher level of healthcare resources with the potential to overload the system with higher costs for treatment and disease control. New technologies aimed at controlling the progression of HIV-1 and CD4+ cell counts can contribute to better quality of life and reduced healthcare resource utilization by the Sistema Único de Saúde (SUS).
Code
EE621
Topic
Economic Evaluation
Disease
Drugs, Infectious Disease (non-vaccine)